[This was originally written and posted to nmcannabisreview.com in 2013/2014, but that website disappeared in November 2014.]
If you are a chronic pain patient stuck in the merry-go-round of current “standard” treatments, I am here to offer you a little hope. No, this is not the false hope provided by so many other treatments for pain — this is an alternative that has been working for a lot of pain patients, including me.
I know what it is like to be a chronic pain patient dependent on doctors and prescription medications, and I know the fear you feel in contemplating leaving all of that behind.
What if you can’t handle the pain? Not everyone will be able to manage their pain without the help of Big Pharma, so please don’t think this has to be your goal. Pain is as unique as your DNA and should be treated however best suits your condition and circumstances.
This is about alternatives…
Let’s start with some definitions:
“Chronic pain is defined as pain that has lasted longer than three to six months, though some theorists and researchers have placed the transition from acute to chronic pain at 12 months. Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months duration, and subacute to pain that lasts from one to six months. A popular alternative definition of chronic pain, involving no arbitrarily fixed duration, is “pain that extends beyond the expected period of healing” Wikipedia
Intractable pain has been defined as “a pain state in which the cause of pain cannot be removed or otherwise treated and which in the generally accepted course of medical practice no relief or cure of the cause of the pain is possible or none has been found after reasonable efforts that have been documented in the physician’s medical records.”
The History I’ve Lived
In 1989, Texas was the first state to enact an Intractable Pain Treatment Act, which is a statute intended to improve access to pain management by providing physician immunity for prescribing opioids to relieve intractable pain.
“Some states, including Michigan, have worked to remove ambiguities and restrictions from their intractable pain treatment acts. In 2001 Michigan became the first state to delete the term intractable pain from its statute, making its provisions applicable to pain in general. More recently, California, Oregon, and Rhode Island repealed a number of restrictive provisions from their IPTAs, including removing the term and definition of intractable pain.” https://www.atrainceu.com/course-module/1473356-65_michigan-pain-and-symptom-module-01
Chronic pain patients have been under siege since the beginning of Reagan’s “Just Say No” campaign. And while Texas was the first state to enact legislation to protect pain specialists and increase access for treatment, it was also one of the first states where the State Medical Board became militarized in working with the DEA.
And the DEA knows what they’re doing. Pain patients became seen as criminals, drug seekers, addicts, and fakers; the doctors their co-conspirators and drug dealers. This unfair and governmentally-funded stigma has continued for decades, leaving pain patients to find relief wherever they can — legal or not.
A lot of chronic pain originates as undertreated acute pain; and for a large number of chronic pain patients, standard treatments are unsuccessful (especially in the long-term). This allows pain levels to increase even further, with the result usually ending with intractable, disabling pain. The DEA, undertreated pain, and an aging population have given rise to an epidemic of chronic pain in the U.S., where it is estimated that over 100 million people suffer from some form of chronic pain.
If you have been a chronic pain patient for the last 10 years, you have seen a dramatic decrease in your options for non-invasive treatments (including prescription medications); an equally dramatic decrease in the number of pain specialists who provide non-invasive treatments; and more rules and regulations that have just made everything worse.**
In other words, it’s downright nasty out there for pain patients. Where are we supposed to turn? Since I have lived in Texas most of my life, and as a long-time intractable pain patient, I made plans, saved money, and moved to New Mexico to enter its medical marijuana program.
It wasn’t that easy, of course. First, I had to completely give up on the pain management industry, and this included halting my seemingly endless search for consistent pain management and relief. In other words, no more prescriptions, and no more pain specialists.
My body rebelled; but, as you can see, I survived. (Abruptly stopping any prescription medication is seriously not recommended.)
I can’t tell you how freeing it is to be in control of my own pain management decisions. For the year that I’ve been a medical cannabis patient, I no longer had to visit a pain doctor every month, sitting like a child at the feet of a man who controlled access to my pain relief (while he spent my office time talking to other patients on the phone).
I no longer had to submit charts to this dictator every month, accounting for each and every pill I took. I didn’t have to make that monthly trip to Walgreens, wondering if my prescriptions would be delayed or withheld, or face some newbie pharmacist intent on explaining how she has decided to refuse (on her own) to fill one prescription or another. I don’t have to worry about my insurance company deciding that, after aggregating purchases of my medications for the past 3 months, the prescriptions I was supposed to pick up that day won’t be filled for another 3 days.
I no longer have to waste time educating medical professionals about chronic pain — trying to teach people things they should already know can be rather irritating (and stressful), especially when you’re paying for their time and expertise.
Of course, the Medical Cannabis Program in New Mexico is no picnic; but treating chronic pain with medical cannabis should be.
Chasing Pain Relief
Along with turning your back on the pain management industry, patients need to accept that chronic pain cannot be cured; it can only be managed. And managing pain is a 24/7/365 job — no holidays, no breaks, no sick days.
Marijuana does not actually provide “relief” for intractable pain patients — it’s not a cure-all. If you’ve got good bud, the effect can give you the ability to distract yourself from the constant pain. You can meditate all day long, but unless you have magical powers, you will not be able to match the effects and benefits of medical cannabis.
After over 25 years of chasing pain relief, I am here to tell you that relief is best thought of as momentary. Those brief seconds in time, when you are able to miraculously push the pain aside — in your mind. And cannabis allows for more of those brief seconds in time.
These brief seconds in time can give a pain patient the impetus to move when their brain is telling them it hurts too much to do so. And the additional pain caused by physical activity is more easily managed when you know that there is adequate medicine awaiting you, if and when you need it.
I like to compare my nervous system on chronic pain as an emergency alert system that is broken; instead of only signaling in an emergency, the system continually broadcasts alerts in a never-ending loop (any Lost fans in the audience?). Unfortunately, no one really knows how to fix this system, and I’m of the opinion that once it’s broken, it can’t be fixed.
I don’t think chronic pain can be managed with psychotherapy or antidepressants. And no more cortisone or Botox injections for me. No more off-label use of anticonvulsants or antipsychotics. No more surgery. No more paying for physical therapy I can do at home.
No more drugs that space me out and cause untold negative side effects. (No more taking even more drugs to combat all the side effects.)
I’m not interested in having a pain pump or a spinal cord stimulator surgically inserted; nor am I interested in neurosurgical treatments (http://www.ncbi.nlm.nih.gov/pubmed/20837190).
With such a narrow list of options, I chose the safest.
Distraction is the key — but it is hard to accomplish. Medical cannabis makes it a little easier. There are patients who have the ability to utilize this pain management tool (distraction) without the use of any substances; but these are abilities that take a very long time to learn, and there will always be a large percentage of patients who are unable to acquire them.
Chronic pain syndromes come with comorbid conditions like anxiety, depression, and anger. Standard treatments for anxiety, like Xanax or Valium — or for depression and anger, like antidepressants — cannot match the effectiveness of marijuana.
I’m not trying to convince any pain patient to do what I’ve done, but I think it’s pretty amazing that I could switch a bucket full of prescription drugs for just one plant. And I sincerely think that medical cannabis should be an option for the treatment of pain — any pain. But I also think that marijuana should be one of the first options available for chronic pain patients — available to them before the pain moves to intractable levels.
And while the medical establishment moves like molasses to provide scientific evidence (through human trials) of the medical benefits of cannabis, the anecdotal evidence (and a U.S. patent) have been enough for patients with nowhere else to turn. Pain patients who still have options may not be interested in trying medical cannabis at this time — but I guarantee you that someday, a lot of them will.
I have researched, experienced, and analyzed New Mexico’s Medical Cannabis Program as a chronic pain patient; and if you are a patient in another state, I recommend you move to Colorado (or maybe Oregon). It takes a lot of research to find the best program for your individual needs as a pain patient, but as with New Mexico’s program, the right information can be hard to find.
There are numerous cannabis websites and forums (almost all of them have been cited somewhere on this website); but if you’ve found your way to this one, then you have probably been looking around for awhile. I know how that feels. So, let me introduce myself: My name is Johnna Stahl a/k/a painkills2, the author of the majority of posts currently on this site. I have tried to provide information that would help other pain patients, but if you have further questions, you can reach me at firstname.lastname@example.org.
Free the weed.
On June 30, 2009, a federal advisory board voted to recommend that the Food and Drug Administration (FDA) ban Percocet and Vicodin. These medications are combinations of opioids with acetaminophen, the active ingredient in the pain reliever, Tylenol. The synergistic properties of these medications meant that working together they often do a better job of controlling pain than either one alone.
Acetaminophen is the most commonly used medication to relieve pain. In 2005 over 28 billion doses were sold, many in over-the-counter (OTC) preparations. Between 1990 and 1998, there were approximately 56,000 emergency department visits, 26,000 hospitalizations, and 458 deaths per year linked to acetaminophen use (FDA, 2009).
In January 2011 the FDA announced that it would sharply restrict, but not ban, the painkillers under review.